Low incidence of seizures in patients with chronic subdural haematoma.

Seizures in Subdural Hematoma

“…This information greatly favors the use of prophylactic AEDs in acute SDH. Reduction of seizures from the prophylactic use of AEDs in chronic SDH is more controversial [12,13,15,56,57]. Although AEDs are not routinely used in this setting in the absence of a clinical suspicion of seizures, seizures should always be considered when the clinical progress is not as anticipated.…”

“…Worsening seizure frequency or status epilepticus in patients with chronic subdural hematoma of any size that has failed medical management with AEDs warrants surgical intervention. Most of the seizures related to SDH occur within 3 months following injury [13] making it reasonable to maintain prophylactic AEDs for at least 3 months following the SDH occurrence unless seizures occur. For patients who experience seizures several months following the SDH occurrence, the seizure management is similar to other forms of symptomatic epilepsy.…”

“…The surgical techniques employed in the treatment of SDH might also be important in the pathogenesis of seizures. Although the SDH capsule is thought to be the source of epileptogenesis, the incidence of postoperative seizures in patients who underwent capsulotomy was higher than in those who underwent burr-hole drainage [13,17,20]. This suggests that cortical injury and gliosis due to either surgical intervention or the SDH itself can result in late seizures [17].…”

“…The latter rate is similar to the one experienced by TBI without SDH. The risk of developing seizures in patients with chronic SDH ranges between 2.3 and 17 % depending on the type and severity of the head injury [12][13][14][15][16]. Clinical and radiological risk factors for developing seizures associated with chronic SDH include brain atrophy, mixed-density SDH, prior stroke, and low Glasgow Coma Scale (GCS) at presentation [16][17][18].…”

Prophylactic antibiotics and anticonvulsants in neurosurgery

“…The frequency of pre-and post-operative seizures in these patients is not established. The overall incidence of seizures in patients with CSH has been reported to vary from 2.3 to 17% [70,83] with an incidence of post-operative seizures reported from 1.0 to 23.4% [48,54]. The wide variation in these numbers is probably related to the severity of the head injury and the type of surgical procedure performed in each study.…”